Vascupedia VIEWS

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  • Speciality: Other
  • Country: DE

Activities

Vascupedia VIEWS

Vascupedia VIEWS AAA Course Episode 17: Reintervention for limb graft occlusion

Objectives

  • To discuss when and how to use the different techniques in daily practice.
  • To review bailout options using thrombectomy devices and determine the steps to successful retrieval of the blood flow
Vascupedia VIEWS
February 2, 2021 No Comments
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Warum man Dissektionen behandeln muss – Optimierung von Ballonangioplastie mit dem Tack Endovascular System

  • Warum Dissektionen behandelt werden müssen
  • Das Tack Endovascular System: Wo und Wie | praktische Aspekte
  • Optimierung von PTA im Oberschenkel: Welche Daten gibt es?
  • Optimierung von PTA im Unterschenkel: TOBA II-Daten
Vascupedia VIEWS
January 26, 2021 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 16: Reinterventions for type Ib endoleak

Objectives:
– To understand principles of device- and anatomy related complications
– To discuss potential complications of type Ib endoleaks
– To explore management options in challenging scenarios
– Worth of preserving the hypogastric artery, bell-bottom vs iliac side branch

Vascupedia VIEWS
January 19, 2021 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 13: Reintervention after EVAR

Objectives:
– To review the current limitations of EVAR in challenging aortic anatomies
– To learn how to apply the different repair techniques and choose the aortic clamping sites during conversion.

Vascupedia VIEWS
December 15, 2020 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 12: Surveillance: how and how often – best medical treatment

Objectives:

  • To translate new scientific knowledge into meaningful advances in patient care
  • To understand the role of Duplex and CT imaging in defining follow-up frequency after EVAR
  • To review how surveillance can be tailored to postoperative endoleak/rupture risk
Vascupedia VIEWS
December 8, 2020 No Comments
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IVUS GUIDED VENOUS RECANALISATION: EVIDENCE TO TREAT WHAT YOU REALLY SEE

Interactive webinar recorded 01/12/20

Topics

  • – IVUS guided venous recanalization: How to do it
  • – Computed tomography venography vs. intravascular ultrasound in the diagnosis iliofemoral vein stenosis
  • – Future of IVUS based therapies for venous leg ulcers
  • – IVUS vs. fluoroscopic guided recanalization for iliofemoral obstruction:
  • Effective option to reduce radiation exposure during intervention.
  • – EUS & IUS guided endovascular venous recanalization

 

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December 7, 2020 No Comments
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WEBINAR – OCT GUIDED ARTERIAL RECANALISATION: EVIDENCE TO TREAT WHAT YOU REALLY SEE

Welcome

Michael Lichtenberg

OCT guided arterial recanalisation: How to interpret it and how do it

Arne Schwindt

Evidence for OCT guided atherectomy

Michael Lichtenberg

OCT-guided imaging work below the knee

Jaafer Golzar

Recorded case example of OCT imaging

Christos Rammos

Final discussion and closing remarks

Michael Lichtenberg

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November 25, 2020 No Comments
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Vascupedia VIEWS

Vascupedia VIEWS AAA Course Episode 11: Postoperative care – Postop and the morning after, what to check before going home, PIS, need for ICU?

Objectives:

  • To learn about postoperative management in patients who have undergone EVAR
  • To discuss how to manage anticoagulation in combination with antiplatelet therapy

 

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November 24, 2020 No Comments
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Vascupedia VIEWS

Vascupedia VIEWS AAA Course Episode 10 :Troubleshooting: Renal artery coverage – Demanding cannulation of the contralateral limb – Intraoperative stenosis or occlusion of the contralateral limb – Intraoperative type Ia and Ib endoleak

Objectives:

  • To gain experience in technical aspects. Need for additional assessment and/or procedures.
  • To learn specific details of complex aortic procedures
  • To explore bailout options using existing devices
Vascupedia VIEWS
November 17, 2020 1 Comment
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 9: Percutaneous access – What are the implications of morbidity, length of stay, and costs? – Large bore closure devices: lessons learned, future directions

Objectives:

  • To learn when and how to apply percutaneous technique; to learn safe femoral artery puncture and secure hemostasis.
  • To determine the steps of successful procedure in case of device dysfunction
  • To understand the different roles of dedicated vessel closure armamentarium
Vascupedia VIEWS
November 10, 2020 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 8: EVAR with infrarenal fixation – Step-by-step procedure

Objectives:

  • To appreciate the clinical settings in which infrarenal fixation is most accurate and effective in order to identify candidates for this device
  • To learn optimal techniques for treating AAA in different anatomical subsets
Vascupedia VIEWS
November 3, 2020 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 7: EVAR with suprarenal fixation – Technologies available today

Objectives:

  • To get knowledge and experience in the indication for EVAR with this type of device
  • To discuss how the use of suprarenal fixation may improve the long-term results of EVAR
  • To translate new scientific knowledge into meaningful advances in patient care

 

Vascupedia VIEWS
October 27, 2020 No Comments
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Comment on Oct 24, 2020

Athanasios Saratzis replied to your comment on presentation VascupediaVIEWS AAA Course Episode 5: EVAR – Challenging “Renal Patient”.

»Indeed! Interesting publication which shows that stenting 4mm accessory renals when the neck is adequate is feasible. The definition of what is a "clinically relevant" accessory renal remains arbitrary though. The only way to assess what constitutes "clinically relevant" in terms of accessory renal preservation in EVAR would be randomisation; however, given how rare this clinical scenario is, we would really struggle to achieve power. I think it's a case by case judgement call... definitions will probably remain arbitrary & driven by expert opinion in this setting. To add to the complexity, assessing % of renal parenchyma supplied by a certain artery is really not very easy or accurate pre-operatively. An interesting area for future research!«
Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 6: EVAR – Challenging aortic neck

Objectives:

  • To learn about specific complexity of some challenging situations
  • To share expected and unexpected experiences and how to deal with them
  • To demonstrate bailout procedures using limited devices that are available within a limited time window
  • To learn how to plan the procedure when the aortic neck is short/ angulated/ tapered/ bulked
Vascupedia VIEWS
October 20, 2020 No Comments
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Comment on Oct 13, 2020

Konstantinos Donas commented on presentation VascupediaVIEWS AAA Course Episode 5: EVAR – Challenging “Renal Patient”.

»Thank you Dr. Beropoulis and Dr. Saratzis for the nice overview! Regarding the mentioned lack of evidence in accessory renal arteries, I would like to use the opportunity and mention the study from Dr. Abu Bakr who recommended the use of chimney grafts in ARAs which supply one-third of the renal parenchyma, and having a diameter >4 mm. The work was published in JEVT in 2016 and represents as you know, dear Efthymios, our general practice in my previous Hospital in St. Franziskus Hospital in Münster for those patients. Thank you again and best regards.«
Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 5: EVAR – Challenging “Renal Patient”

Objectives:

  • To learn how to manage your patient with renal insufficiency: medication, alternative imaging possibilities, role of supra- or infrarenal fixation on renal function outcome
  • To discuss how to deal with accessory renal arteries, what size is worth saving and how?
  • Best option in horseshoe kidney
Vascupedia VIEWS
October 13, 2020 3 Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 4: Treatment of infected aortic endograft, mycotic and inflammatory aneurysm

Objectives:

  • To learn the assessment of severity in patients with infection
  • To discuss the management of device-related complications
  • To discuss how to decide between EVAR and open surgery
  • To learn how to optimize the strategy and techniques in open surgery in case of conversion.
Vascupedia VIEWS
October 6, 2020 No Comments
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Vascupedia VIEWS

VascupediaVIEWS AAA Course Episode 3: Open Surgery for AAA

Objectives:

  • To learn how to optimize the strategy and techniques in open surgery.
  • To learn different accesses to the aorta
  • To discuss the indication and technique of supraceliac, suprarenal and infrarenal clamping
Vascupedia VIEWS
September 29, 2020 No Comments
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Vascupedia VIEWS

VascupediaVIEWS Part 2 Episode 2: Emergent/Ruptured AAA – EVAR or open surgery? Strategies to optimize ruptured AAA outcome

Objectives:

  • To appreciate the management of aneurysm rupture in difficult clinical settings
  • To learn which patient would benefit from which therapy?
  • To discuss how to make strategic decisions in different clinical situations and make a treatment algorithm for stable and unstable patients
  • To learn about diagnostic and timing of repair in patients with abdominal compartment syndrome
Vascupedia VIEWS
September 22, 2020 3 Comments
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Vascupedia VIEWS

VascupediaVIEWS Part 2 Episode 1: Elective AAA – From imaging to decision making & planning

Objectives:

  • To learn how to interpret CT-angiography in different AAA scenarios
  • To learn how to assess the underlying anatomy and plan the treatment
  • To discuss how to decide between EVAR and open surgery
  • To discuss the best treatment options for patients presenting with AAA
Vascupedia VIEWS
September 15, 2020 4 Comments
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Comment on Jun 30, 2020

Kinya Matsui commented on presentation Vascupedia VIEWS Episode 11 Endovascular therapy for failed distal bypass is possible and safe than re-do open surgery.

»Great talk.Thank you very much. No vein,No bypass? Good saphenous vein is ideal for bypass graft in vascular reconstruction of below knee region. Occluded prosthetic graft approach is good option for new vascular access of EVT? Heavy calcification is bad for DCB&DEB. To be or not to be,Lost of endothelial stem cells/CD157 ,,aging.that's the question,I think.«
Comment on Jun 22, 2020

Kinya Matsui commented on presentation Vascupedia VIEWS Episode 7 Calcium: what to do against the worst enemy?.

»Calcium is essential for life. calcification is end stage of arteriosclerosis. it may strengthen aneurysmal wall against pressure. Yesterday's enemy is today's friend. Today's enemy is still future's one? ectopic calcification is troublesome. We wish that we will be able to handle it in future.«
Vascupedia VIEWS

Vascupedia Views Episode 9 Percutaneous Deep Vein Arterialization (pDVA) Essentials – Patient Identification, Key Success Factors, and 2 Year ALPS Registry Data with the LimFlow System

Vascupedia Views Episode 9

Percutaneous Deep Vein Arterialization (pDVA) Essentials – Patient Identification, Key Success Factors, and 2 Year ALPS Registry Data with the LimFlow System

Dr. R. Ferraresi (IT) + Dr. S. Kum (SGP)

Moderator: Dr. T. Bisdas (GR)

Vascupedia VIEWS
June 10, 2020 No Comments
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Vascupedia VIEWS

Vascupedia VIEWS Episode 6 Vein bypass grafting: tips and tricks to beat all endovascular techniques

Vascupedia Views Episode 6

Vein bypass grafting: tips and tricks to beat all endovascular techniques

Dr. Hany Zayed  (UK)

Moderator: Dr. Lorenzo Patrone (UK)

Vascupedia VIEWS
May 20, 2020 3 Comments
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Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Ahmed, Thank you for your question. The drilling technique (which I have used only four times in my life) needs to be done at the point where it is needed (the most calcified point usually) and, generally speaking where the balloon can’t pass. My first case has been a proximal peroneal artery where despite having the wire through and through between antegrade and retrograde access, I was unable to pass any 0.014 or 0.018 balloon.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Tahir, Thank you for your question. In that particular patient after one week from the amputation there was no granulation tissue and the margins started becoming necrotic. For this reason, clinically, something needed to be done not to loose the forefoot or, even worse, the leg. After the revascularisation procedure the patient started doing better and he completely healed after few months. There are trials which are showing the benefit of the BTA treatment and I have also cited one of them during my lecture. My personal mantra is that if you have tissue loss you need to do everything you can to establish proper in line flow to the ulcer because this makes a difference in terms of wound healing.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Lorenzo, Martin and Michel, Thank you for your questions which I decided to group here. My workhorse wires are the Command 0.014 (Abbott) and Helberd 0.014/0.018 (Asahi). I use the Helberd in case of CTO and I make sure to drill and not to push to avoid the risk of perforation. I sometimes use the PT Grafix (Boston Scientific) when I want to get into a very tiny vessel through a tight stenoses and I want to be atraumatic. Remember that this wire gives you very poor support and the tip is very easy to get the tip damaged so it’s not indicated in case of CTO. Generally speaking I tend anyway to use 0.014 wires instead of 0.018 ones and this is particularly important when going below the ankle. I also need to mention the Half stiff Terumo when I go subintimal. Because of its diameter when compared to the ones already mentioned and its stiffness it’s ideal to avoid the risk of perforation. To answer to your second question I try to use low profile balloons to support my wire for two main reasons: I avoid the cost of a microcatheter (which instead I always use for my retrograde approaches made by V18 and CXI) and I am sometimes able to create my way through the occlusions by perform angioplasties in most stenotic/calcific tracts. I tend to use short low profile balloons like Armada XT or Across CTO BTK.«
Comment on Apr 21, 2020

Vascupedia VIEWS commented on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Ballon catheter or support catheter for BTK recanalization? Lorenzo Casadei What is your preferred wire to recanalize? And what is your preferred wire if you are subintimal to go back in to the true lumen? Michel Bosiers Which is your workhorse wire for BTK and below the ankle interventions? Lorenzo Casadei Which wire do you use for CTO ? Martin Schroeder«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Marc, This is actually a great question. I personally evaluate the immediate, short term and “long term” (20 minutes after the inflation of the balloon) reaction of the vessel to angioplasty and then I take a decision. In same cases as TP trunk occlusion in Rutherford 5 or 6 patients I often don’t trust the angioplasty result and I stent primarily. I am also very keen of stenting the origin of completely occluded vessels because I often consider the need to obtain the best flow in a vessel which inevitably presents multiple dissection flaps.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Silveira, Thank you for your question. There is an interesting paper published in 2017 about these patients sci-hub.tw/10.1177/1538574417744085. In my practice I have seen that the thickness of the vessels under US is a good predictor of success. When the AT or PT is occluded and with thick walls, the chances of success are very poor because the vessel will react badly to angioplasty. In all the Buerger’s disease patients which I treated I used CTO wires (being extremely gentle and drilling without pushing) especially to engage the stump. Be gentle and fight hard for these patients. They deserve it!«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Said, I never use DEB in BTK. You can check INPACT deep randomised control trial. One-year and five-year results show how the results are comparable with amputation rate and freedom from TLR worse in the Paclitaxel group. The recent discussed methanalysis of Katsanos dedicated to Paclitaxel at the BTK level confirms higher rate for all cause death and major amputation in the drug elution group. The main mechanism could be due to distal microembolisation. New products are coming on the market which show a different coating and which could lead to better result but still no randomised control trial confirm better clinical results in the group treated with DEB. As mentioned before the combination between vessel prep and DCB looks promising but still there is no evidence supporting this expensive treatment in terms of wound healing and amputation free survival.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Giacomo, Thank you for your question. I never noticed stent fracture in the patients which I treated but it is also true that luckily not many of them come back for treatment and my knowledge about the actual rate of stent fracture could be biased. The important thing is not to stent at/below the ankle level. In particular the PT has a very impressive range of movements during the dorsiflexion of the foot. In a patient referred to us from an other centre I have once seen a stent completely smashed in the dorsalis pedis. This preclude any other option of endovascular treatment.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Lorenzo, thank you for your question. In case of desert foot, I usually try to do superselective injections in the anterior tibial artery or posterior tibial artery to try to show any possible distal landing zone for my angioplasty. Bone landmarks can be useful to understand vessel anatomy but they are not able to guide a blind revascularisation, at least in my experience.«
Comment on Apr 21, 2020

Vascupedia VIEWS replied to your comment on presentation Vascupedia Views Episode 1 BTK: tips & tricks to suceed in your revascularization.

»Dear Adam, thank you for your question. The DES (everolimus and not paclitaxel) commonly used are derived from the cardiological experience. These have demonstrated to be very effective for short to medium lesions (I mentioned in my talk the paper of Spiliopoulos). No stent should be deployed around the ankle level or lower because the risk of stent fracture is extremely high due to the movements of the foot. DCB in below the knee still didn’t demonstrate superiority to normal PTA. The combination between vessel preparation and DCB looks promising but still there is no proper scientific evidence to support their use.«